Provider Demographics
NPI:1033356886
Name:A CHILD'S WAY THERAPY LLC.
Entity Type:Organization
Organization Name:A CHILD'S WAY THERAPY LLC.
Other - Org Name:DEVELOPMENTAL PEDIATRIC SKILLS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:KLEKAMP
Authorized Official - Last Name:GUNNER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:919-345-3411
Mailing Address - Street 1:5241 WILDMARSH DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-6571
Mailing Address - Country:US
Mailing Address - Phone:919-345-3411
Mailing Address - Fax:919-845-6224
Practice Address - Street 1:5241 WILDMARSH DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-6571
Practice Address - Country:US
Practice Address - Phone:919-345-3411
Practice Address - Fax:919-845-6224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38792251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty